A New Paradigm in Strength Training and Rehab

23 Dec A New Paradigm in Strength Training and Rehab

The Joint By Joint Approach A New Paradigm in Strength Training and Functional Rehabilitation The following is based heavily on the views of Gray Cook, Michael Boyle, Shirley Sahrmann and others. Gray Cook and Mike Boyle have certainly been instrumental in educating strength coaches and physical therapist on the need to approach not only physical therapy and rehabilitation, but also strength training using this Join by Joint approach. Gray has said that in the past, we in the field of physical medicine and rehabilitation leave a ton of things on the table when it comes to issues we are not addressing in rehabilitation. This basically stems from the fact that almost all orthopedic sports medicine from conservative to surgical intervention, is based on an acute trauma based model. From sprains/ and strains to fractures, dislocations, muscle and ligament tears, most of our treatment approaches are geared towards these traumas. From RICE and inflammatory medications, muscle relaxors to pain management to surgical correction, all things we excel at from a trauma based view. If we tear a ligament or rupture a muscle, surgery can repair or replace the damaged tissue. Moderate arthritic knees can be debrided and surgeons can do microfracture(punching tiny holes into the bone to create bleeding in an attempt to stimulate new cartilage growth). A traumatic shoulder dislocation can result in a Bankhart tear that can be surgically repaired. Even severe arthritis can be corrected with total joint replacement. But what about correcting the biomechanics and muscle imbalances that lead to early joint degeneration in the first place? And what about optimizing human performance? When it comes to overuse and chronic repetitive, gradual onset injuries, we need a different approach. The joint by joint approach starts from the ground up. According to Gray Cook in his three part article on http://www.strengthcoach.com/ “Our modern bodies have started developing tendencies. Those of us who are sedentary, as well as those of us who are active, seem to migrate to a group of similar mobility and stability problems. Of course you will find exceptions, but the more you work in exercise and rehabilitation, the more you will see these common tendencies, patterns and problems”. A quick summary looks goes like this 1. The foot has a tendency toward sloppiness and therefore could benefit from greater amounts of stability and motor control. We can blame poor footwear, weak feet and exercises that neglect the foot, but the point is that the majority of our feet could be more stable. 2. The ankle has a tendency toward stiffness and therefore could benefit from greater amounts of mobility and flexibility. This is particularly evident in the common tendency toward dorsiflexion limitation. 3. The knee has a tendency toward sloppiness and therefore could benefit from greater amounts of stability and motor control. This tendency usually predates knee injuries and degeneration that actually make it become stiff. 4. The hip has a tendency toward stiffness and therefore could benefit from greater amounts of mobility and flexibility. This is particularly evident on range-­of-­motion testing for extension, medial and lateral rotation. 5. The lumbar and sacral region has a tendency toward sloppiness and therefore could benefit from greater amounts of stability and motor control. This region sits at the crossroads of mechanical stress, and lack of motor control is often replaced with generalized stiffness as a survival strategy. 6. The thoracic region has a tendency toward stiffness and therefore could benefit from greater amounts of mobility and flexibility. The architecture of this region is designed for support, but poor postural habits can promote stiffness. 7. The middle and lower cervical regions have a tendency toward sloppiness and therefore could benefit from greater amounts of stability and motor control. 8. The upper cervical region has a tendency toward stiffness and therefore could benefit from greater amounts of mobility and flexibility. You can learn more about Functional Movement Screen™ at http://functionalmovement.com/SITE/Read the full three part article here